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FIELD LABORATORY KIT
Missionary Medicine
LAB RESULTS - DIAGNOSIS/MISDIAGNOSIS

Medical tests are considered to be extremely reliable and objective. However, this is a popular misconception. Tests can be just as subjective as a symptom (which is what a patient complains of) or a sign (which is finding noted by the doctor on clinical examination) . In other words, merely conducting more tests does not ensure better medical care.

Keep in mind, laboratory tests are interpreted in the context of other tests and clinical signs and symptoms, as well as personal and family medical histories; one test is rarely, if ever, diagnostic of anything. A meaningful diagnosis is developed through a careful evaluation of all available evidence, weighted with scientific probabilities, and filtered through the professional knowledge, intuition, and clinical experience of the practitioner/diagnostician.

Thus a cooperative, mutually respectful relationship with your healthcare practitioner is of the utmost importance if you wish to be an active partner in your treatment and other healthcare decision- making.

THE AVERAGE, SO-CALLED, MEDICAL CHECK UP, IS IN MOST CASES ONLY A SCREENING FOR OBESITY, DIABETES, HYPERTENSION, HYPERLIPIDEMIA, AND ANEMIA. More...

A RURAL PRIMARY CARE PHYSICIAN CAN IN FACT DO A BETTER JOB WITHOUT THE TECHNOLOGY, USING SIMPLE TESTS, COMMON SENSE AND CARING!

THIS IS A MANUAL AND A REFERENCE WORK. IT IS TO ACCOMPANY ONE OF OUR TRAINING SESSIONS TO LEARN THE USE OF THE EQUIPMENT.

This manual is mainly intended for the rural laboratory. SIGNS and SYMPTOMS related to diseases, as well as their treatment, are to be found in the Grand Master's ENCYCLOPEDIA OF NATURAL MEDICINE, available on CD. There is also more information in the author’s companion book MODERN MONASTIC MEDICINE.

List of Laboratory Tests this Kit can aid in diagnosis:

DISEASE LIST: TESTS WHICH ARE USEFUL FOR DIAGNOSING VARIOUS DISEASES IN RURAL & TROPICAL AREAS

This list is a guide to show when to use the laboratory procedures listed in combination with physical signs and symptoms. It list tests that might be done when you are considering a possible diagnosis, and what a positive result means. Sometimes a positive test confirms the diagnosis and sometimes it leads you to suspect another diagnosis which is the true one. For example, if you think your patient has an acute abdomen but his urine shows glucose, it is possible that his abdominal pains are due to dia betic acidosis. If you think your patient has African sleeping sickness but his sedimentation rate is normal, this eliminates that ,agnosis.
Results & Interpretation: + means Positive result, and - means Negative result. "Confirmative" means that this result could be caused by the disease in question, but it does not imply that the opposite result could never be found. The best tests for a particular disease or symptom are those where a positive result means one thing and a negative result points to anot her, or where there is a clear difference in meaning for different ranges of quantitative measurements.

CONTENTS

1. Rolling Travel Case, aluminum

2. Digital Microscope, 12 volt battery operable, with 3.5 Screen, 40x, 400x and 1600x Magnification (laptop compatible)

3. Full set of reagents, 1 oz. bottles

4. Glucose/cholesterol/uric acid portable meter with reagent sticks.

5. Refractometer

Note: Kit not provided to US domestic practitioners.

 
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Our first kit was developed on Nevis Island and field tested in Cebu, Philippines, following in the mountains of Nepal.

 DISEASE

SPECIMEN

TEST

RESULTS & INTERPRETATION

Acute abdomen

Urine

Glucose

+ consider diabetic acidosis

 

Urine

Ketones

+ confirmative, consider diabetic ketoacidosis

 

Urine

Urobilinogen

+ consider malaria, thallasemia, sickle cell disease, other liver disease, drug intoxication

 

Urine

Nitrite

+ consider urinary tract infection

 

Urine

Bilirubin

+ consider hepatitis, leptospirosis, other liver disease

 

Stool

Blood

+ consider enteric (typhoid) fever

 

Blood smear

Blood smear: Schizonts Trophozoites Gametocytes

Patients can present with acute abdominal pain, guarding and rigidity, mimicking bowel perforation, acute appendicitis, acute cholecystitis, ureteric colic, etc. (Malaria can mimick almost anything!)

 

 

 

 

 African sleeping sickness

Blood

Sedimentation rate

Very high (above 60), confirmative;   Intermediate (30-60), doubtful;  Normal (below 30), eliminates

Human African Trypanosomias

Blood

Blood smear

A wet smear of unstained blood or Giemsa-stained thick smear (more sensitive) is used to observe the mobile trypanosomes It requires immediate search for parasites because they are mobile for only 15-20 minutes.

 

Blood

Hemoglobin

Low, confirmative

 

Lymph

Lymph node aspiration

A rapid test for trypanosomes at a high dry magnification (X 400). It requires immediate search for parasites because they are mobile for only 15-20 minutes.

 

Cerebrospinal fluid

Lumbar puncture

Lumbar puncture should always be performed in patients with parasitemia or lymphadenopathy. The double centrifugation technique is the most sensitive method to detect the trypanosomes

 AIDS

Urine

Ketones

+ confirmative

 

Blood

Formol gel

+ confirmative

 

Blood

Hemoglobin

Low, confirmative

 

Blood

Dry Mount

Significant puddling and dyscrasia in active and late stages

 

Saliva

OraQuick dipstick

Orasure Technologies, Medford, N.Y.

 

Blood

Whole blood dipstick

+HIV-1, Hema Diagnostic Systems, U.S.

 Allergy

Urine

Nitrite

+ consider urinary infection

 

Urine

Bilirubin

+ consider liver disease

 

Stool

Hematest

+ consider schistosomes, other worms

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

 

Skin

Patch or Scratch test

+ if skin reddens as a reaction to the antigen

Ameobic liver disease (abscess)

Urine

Bilirubin

ErlichÕs diazo reagent

+ confirmative

+ confirmative Pink or Red

 

Blood

White Cell Count

There is usually a moderate leucocytosis accompanied by an absolute or relative increase in neutrophils.

 

Blood

Hemoglobin

Anemia is common in ALA.

 

Stool

Microscopic

If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.

Ameobic dysentery

Stool

Microscopic

If it reveals cysts or vegetative forms of E. Histolytica, it becomes a valuable aid in the diagnosis. However, in endemic areas, where the incidence of carriers is high, presence of cysts of E. Histolytica should not be given too much importance.

 

Blood

White Cell Count

+ Leucocytosis, confirmative

Anemia

Blood

Hemoglobin

+Low; Normal, eliminates

 

Blood

Microscopic

Differential of microscopic and macroscopic forms

 

Stool

Hematest

+ confirmative, helps to find cause

Arterio/Athero-sclerosis

Blood

Cholesterol

+ > 200 mg.%

 

Blood

Microscopic Live Blood

+ Cholesterol chards

 

Nails

Capillary refill time

+ > 2 seconds

 

Skin

Head to toe temperatures

+ If the head temperature is 3¼C > than temp. at the bottom of the feet.

Arthritis

Blood

Sedimentation rate

Normal, implies arthritis due to previous injury or old age; High, implies other kinds of arthritis

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

 

 

 

 

Ascariasis

Urine

Ketones

+ indicates severe case

 

Stool

Microscopic

+ characteristic ova

 

Blood

White Cell Count

+ Eosinophilia

Asthma

Urine

Nitrite

+ consider urinary infection

 

Urine

Bilirubin

+ consider liver disease

 

Stool

Hematest

+ consider schistosomes, other worms (until proven otherwise)

 

Stool

Clinitest (4)

+ confirmative or milk intolerance

 

Blood

White Cell Count

+ Eosinophilia indicates allergy and/or parasitosis

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Cancer

Blood mount

Lagoons with broken fields

+ confirmative

 

Blood

Sedimentation rate

High, severe disease, spreading malignancy

Normal or low, early disease or none

 

Blood

Hemoglobin

Low, confirmative

 

Urine

Carcinochrome reaction

+ Confirms, or raises suspicion levels when albuminuria is present

 

Blood

HartmanÕs & Koch Crenation Test

+ When 5 or more RBCÕs fail to crenate in 1% saline, in a microscopic field

 

Blood

Blood smear

+ characteristic presence of increased platelets (thrombocytosis)

Cancer, Cervical

Epithelial scraping

Pap test cytology

+ characteristic change in nuclei

 

Epithelia

SchillerÕs test

+ if cervix fails to retain tincture of iodine stain

Cancer, Bladder

Urine

Pap test cytology

+ characteristic change in nuclei

Cancer, Bronchopulmonary

Bronchial aspirate (sputum)

Pap test cytology

+ characteristic change in nuclei. Morning collection of sputum in smokerÕs can be preserved in vodka.

Cancer, Gastric

Gastric contents

Glycyltrophan test

+ Reddish color on addition of glucose & bromine

Cancer, Melanoma

Urine

ThormahlenÕs test

+ Deep blue color

 

Urine

Ferric chloride

+ Deep black color

Chaga's disease

Urine

Bilirubin

+ confirmative

American Trypanosomiasis

Urine

Urobilinogen

+ confirmative

Chlamydia

Whole Blood

Dipstick

+ confirmative; Hema Diagnostic Systems, U.S.

Cholera

Urine

Urobilinogen

+ consider malaria

 

Stool

Clinitest

- for cholera; confirmative for osmotic diarrhea or milk intolerance (a sensitive differential diagnosis)

Chronic Obstruc-tive Pulmonary Disease

Breath

Breath holding <20 sec.

Pitting edema

Capillary refill > 2 sec.

Tachycardia, dyspnea

 + confirmative

 

Breath

Match Test

+ Failure to blow out a match held 6 inches out, exhalation through pursed lips

Cirrhosis, hepatic

Urine

Urobilinogen

+ confirmative

 

Urine

Bilirubin

+ confirmative; - eliminates

 

 

 

 

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

 

 

 

 

Colic (simple)

Stool

Blood

+ consider some other cause

 (see also acute abdomen, gall bladder disease, dysentery)

 

 

- confirms simple colic

 

Stool

Clinitest

+ consider milk intolerance

 

Enteric

Epsom salt challenge

+ of diagnostic and therapeutic value in Gallstone colic and severe constipation. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic. The ordinary dose as a mild laxative is a heaping teaspoonful; as a cathartic, two to four teaspoonfuls. The taste may be improved, if necessary, by the addition of a little lemon juice and sugar.

Dehydration

Urine

Specific gravity

High, confirmative

Normal or low, eliminates

 

Urine

Color

+ Dark yellow (moderate) to deep orange/brown (severe)

 

Skin

Skin Tenting

High, confirmative

 

 

 

 

 

Dengue fever

Urine

Ketones

+ consistent

 

Urine

Blood

+ may be hemorrhagic fever

 

Stool

Blood

+ may be hemorrhagic fever

Depression

Blood

Sedimentation rate

Normal, confirmative;  High, indicates a physical cause

 

Blood Pressure

Elevated right sided systole & diastole

 

Diabetes

Urine

Glucose

+ confirmative

 

 

 

- mild, well-treated, or over-treated

 

Urine

Ketones

+ confirmative, severe, under-treated

 

Blood

Glucose

+ High, confirmative, needs treatment;  Low, over-treated or eliminates; Normal, well-treated or eliminates

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Diarrhea

Stool

BenedictÕs test

+ Yellow orange to greenish (some sugar) is specific for osmotic diarrhea vs. enteropathic

Dysentery

Stool

Hematest

+ confirmative; - consider ordinary diarrhea

 

Urine

Nitrite

+ confirmative

Enteric (typhoid) fever

Stool

Hematest

+ confirmative, severe case

 

Urine

ErhlichÕs diazo

+ Pink or red

 

Urine

GerhardtÕs acetoacetic acid test

+ deep red

 

Urine

Nitrite

+ confirmative

 

Urine

Russo typhoid reaction

+ Early stages urine change light green to addition of 4 drops methylene blue, emerald green at the height, blue during the decline

 

Blood

White Blood Cell Count

+ Leucopenia

Filariasis

Urine

Protein

+ confirmative

 

Blood

BrugiaRapid

+ specific IgG4 antibodies against Brugia filarial parasites; BioDiagnostic Research SDN BHD, Malaysia

Gallbladder disease; gallstones

Urine

Bilirubin

+ confirmative

 

Enteric

Epsom salt challenge

+ of diagnostic and therapeutic value in Gallstone colic. From 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic.

Gastroenteritis

Urine

Ketones

+ confirmative; - mild disease

 

Urine

Glucose

+ consider diabetes

 

Stool

Clinitest

+ consider milk intolerance

Giardiasis

Urine

Ketones

negative ; if + confirmative

 

Stool

Clinitest

+ consider milk intolerance

Gonorrhea

Urine/pus

Microscopy

+ confirmative with gram negative diplococci (in pairs)

 

Whole Blood

Dipstick

+ confirmative; Hema Diagnostic Systems, U.S.

Heart failure

Urine

Protein

+ confirmative

 

 

Breath holding <20 sec.

Pitting edema

Capillary refill > 2 sec.

Tachycardia, dyspnea

 + confirmative

 

Blood

Leucocytosis

+ confirmative, severe

Heat stroke

Urine

Blood

+ confirmative, severe

 

Urine

Protein

+ confirmative, severe

Hemorrhagic fever, viral

Urine

Blood

+ confirmative

 

Stool

Hematest

+ confirmative

 

Blood

Hemoglobin

Low, confirmative

Hepatitis

Urine

Bilirubin

+ confirmative; - eliminates, or early stage

 

Urine

Urobilinogen

+ confirmative, see malaria also

 

Urine

Ketones

+ confirmative

 

Blood

Dipstick

+ confirmative B & C; – eliminates (KIT Biomedical Research, the Netherlands)

Hookworm

Stool

Hematest

+ confirmative; - improbable if neg. three times

 

Stool

Ova & Parasite

+ However, because egg laying may be delayed, stool examination should not be considered a sensitive test for identifying hookworm infection. Stool examinations may need to be repeated.

 

Blood

Microscopy

+ Macrocytic (iron deficiency) anemia

 

Blood

Hemoglobin

Low, confirmative

 

Blood

White Cell Count

+ differential reveals eosinophilia (1000-4000 cells/mcL)

Hypoglycemia

Blood

Glucose

Normal or high, eliminates;   Low, confirms

 

 

 

 

Intestinal fluke

Urine

Ketones

+ confirmative

 

Stool

Clinitest

if + consider milk intolerance

Irritable bowel

Stool

Hematest

if + consider another cause

 

Stool

Clinitest

if + consider milk intolerance

Jaundice

Urine

Bilirubin

+ confirmative; - eliminates, or early stage

 

Urine

Urobilinogen

+ confirmative, - seen in obstructive jaundice

 

Blood

HamelÕs test

+ serum yellow

Kidney failure

Urine

Protein

+ confirmative, esp. nephrotic

 

Urine

Blood

+ confirmative

 

Urine

Specific gravity

VolhardÕs (AlbarranÕs) dilution test

 

Blood

Hemoglobin

Low, confirmative;  Normal, recent onset or eliminates

 

Breath odor

Fetid, fishy, metallic

+ indicates accumulation of ammonia and urea

 

 

 

 

Kidney infection

Urine

Nitrite

+ confirmative; - early or eliminates

 

Urine

Blood

+ confirmative; - early or eliminates

 

Urine

Protein

+ confirmative

 

Urine

pH

pH 8 or higher, confirmative

 

Urine

GerhardtÕs acetoacetic acid

+ Deep red color

Kidney stone

Urine

Blood

+ confirmative; - not always eliminates

 

Urine

Microscopy, SternheimerÕs stain

pH <6.5: oxalate crystals/stones

pH >7.0: staghorn calculi

 

Back

Kidney Punch

+ Costovertebral tenderness

Lassa fever

Urine

Blood

+ confirmative

 

Stool

Blood

+ confirmative

 

Blood

Hemoglobin

Low, confirmative

Lead poisoning

Blood

Hemoglobin

Low, confirmative

 

 

 

Normal, mild, recent, or eliminates

Leprosy

Blood

Dipstick

+ confirmative; – eliminates (KIT Biomedical Research, the Netherlands)

 

Blood

Formol gel test

+ confirmative; - eliminates, or very early disease

Leptospirosis

Urine

Urobilinogen

+ confirmative

 

Urine

Bilirubin

+ confirmative

 

Urine

Protein

+ confirmative

Liver failure

Urine

Bilirubin

+ confirmative; - eliminates

 

Urine

EhrlichÕs diazo

 + pink or red

 

Urine

Urobilinogen

+ confirmative

Liver fluke

Urine

Bilirubin

+ confirmative

Lyme disease

Blood

Live Blood microscopy

+ Spirochetes will crawl out of the RBCÕs sitting 4 hrs. at room temperature

Malabsorption

Urine

Ketones

+ confirmative

- mild case or eliminates

 

Blood

Hemoglobin

Low, confirmative

 

Stool

Clinitest

+ due to milk intolerance

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Malaria

 

Urobilinogen

+ confirmative; - questionable2

 

Whole Blood

Dipstick

+ confirmative; Hema Diagnostic Systems, U.S.

 

Blood

Hemoglobin

Low, confirmative

Malnutrition

Urine

Ketones

+ confirmative;  - indicates recent food intake

 

Urine

Color

+ Pale, indicates low protein dietary

 

Blood

Hemoglobin

Low, confirmative

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Measles

Urine

ErhlicÕs Diazo reaction

+ confirmative

Meningitis

Urine

Ntrite

+ confirmative

Milk intolerance

 

Clinitest

+ confirms the diagnosis; - eliminates the diagnosis

Mushroom  poisoning

Urine

Bilirubin

+ confirmative

 

Urine

Urobilinogen

+ confirmative

 

Skin snip

Microscopic biopsy

+ examined 15 minutes to 3 hours later to see whether or not microfilariae have emerged

Ovalocytosis

Urine

Urobilinogen

+ confirmative; - questionable 3

 

Blood

Microscopy

+ RBCÕs  oval-shaped instead of round. It is a form of hereditary elliptocytosis.

 

Blood

Hemoglobin

Low, confirmative

Parasites

Stool

EGGS PLUS

+ Eggs > 100 per microscopic field

Pellagra

Urine

pH

+pH of 8+; pH 7 or less, questionable

 

Blood

Hemoglobin

Low, confirmative

 

Urine

Ketones

+ confirmative

Pelvic Inflammatory Disease

Blood

Leucocytosis

+ confirmative, severe

See Chlamydia

Vaginal smear

GramÕs stain

- negative intercellular diplococci

 

Blood

Sedimentation rate

+ Increased

Peptic ulcer

Stool

Hematest

+ confirmative

 

Blood

Hemoglobin

Low, confirmative

Phenylketonuria

Urine

Ferric chloride

+ Deep green color

Pigbel (necrotizing enteritis)

Stool

Hematest

+ confirmative

 

Blood

White Blood Cell Count

+ Leucocytosis (unlike leucopenia of typhoid)

 

 

 

 

Pneumonia

Urine

Bilirubin

+ confirmative

 

Urine

Urobilinogen

ErlilchÕs diazo

+ confirmative

Egg yellow reaction

 

Urine

GerhardtÕs acetoacetic acid

+ Deep red color

 

Urine

FantusÕ test

+ Urinary chlorides decreased

 

Blood

Leucocytosis

+ confirmative, severe

Puerperal fever

Childbed fever

Urine

ErlichÕs diazo

+ confirmative

Relapsing fever

Urine

Bilirubin

 

 

Urine

Protein

+ confirmative, not much

 

Urine

Urobilinogen

+ confirmative

 

Urine

Blood

+ confirmative with severe disease

 

Stool

Hematest

+ confirmative with severe disease

Rheumatic fever

Blood

Sedimentation rate

+ High, confirmative

Rheumatoid Arthritis

Blood

Leucocytosis

+ confirmative, severe

 

Synovial fluid aspirate

Mucin clot test (RopeÕs test)

+ confirmataive, a few drops of 5% acetic acid to 1 ml

 

Synovial fluid

Mucin Clot Test

+ confirmative, severe

Scarlet Fever

Urine

GerhardtÕs acetoacetic acid

+ Deep red color

Schistosomiasis hematobium

Urine

Blood

- eliminates if repeatedly neg.

 

Urine

Hatch Test

+ eggs hatch from miracidia

 

Urine

Microscopy

+ direct examination reveals the eggs

Schistosomiasis japonicum

Stool

Hematest

+ confirmative; - questionable if repeatedly neg.

 

Urine

Microscopy

+ direct examination reveals the eggs

 

Urine

Bilirubin

+ confirmative

Schistosomiasis mansoni

Stool

Hematest

+ confirmative; - questionable if repeatedly neg.

 

Stool

Hatch Test

+ eggs hatch from miracidia

 

Urine

Bilirubin

+ confirmative

 

Urine

Microscopy

+ direct examination reveals the eggs

Sickle Cell Anemia

Blood

Sickling Test

+ confirmative, severe (sickling induced by sodium metabisulfate or ascorbic acid solution)

Scurvy

Stool

Hematest

+ confirmative (swallowed blood); - questionable if repeatedly neg.

 

Urine

Silver Nitrate Test

+ Negative confirmative

 

Blood

Hemoglobin

Low, confirmative

 

Blood

Dry Blood Mount

Pock marks to puddling indicates the amount of free radical damage from the dietary due to silent (humoral) inflammation

Sepsis / Trauma

Urine

Urobilinogen

+ confirmative

 

Urine

Bilirubin

+ confirmative

 

Urine

Protein

+ confirmative

 

Blood

Leucocytosis

+ confirmative, severe

 

 

 

 

Sickle cell disease

Urine

Urobilinogen

+ confirmative;   questionable if repeatedly negative

 

Urine

Bilirubin

+ confirmative

 

Blood

Hemoglobin

Low, confirmative

 

Blood

Microscopy

+ Sickling test postive

Spotted fever

Urine

Bilirubin

+ confirmative

 

Blood

White Blood Cell Count

+ Leucocytosis

Sprue

Stool

pH

pH 6 or less, confirmative

 

 

 

pH 7 or more, eliminates

 

Blood

Hemoglobin

Low, confirmative

 

Strongyloidiasis

Stool

Hematest

+ confirmative

 

Stool

Microscopic, Ova & Parasite

+ confirmative

Thallasemia

Urine

Urobilinogen

+ confirmative

 

 

 

- eliminates, or no current crisis

 

Blood

Hemoglobin

Low, confirmative;  Normal or high, eliminates or mild

 

 

 

 

Syphilis

Whole Blood